Hemorrhoids Grading & Size Chart

Hemorrhoid Size Reference Table (Approx.)

Symptoms of Hemorrhoids by Grade

When to Seek Medical Help?

You should consult a proctologist if:

• Bleeding lasts >1 week

• Pain worsens while sitting or walking

• Hemorrhoids protrude and don’t retract

• There’s a noticeable lump or clot

Diagnostic Methods

• Digital Rectal Examination (DRE)

• Anoscopy

• Proctoscopy

• Colonoscopy (if bleeding origin is unclear)

Treatment Options Based on Grading

Grade I & II

• High-fiber diet

• Sitz bath

• Topical creams (lidocaine, hydrocortisone)

• OTC medications (Daflon)

• Non-surgical methods:

  1. Rubber band ligation

  2. Infrared coagulation (IRC)

  3. Sclerotherapy

Grade III

• May require:

  1. Stapled Hemorrhoidopexy

  2. Doppler-guided hemorrhoidal artery ligation (DG-HAL)

  3. Minimally invasive laser surgery

Grade IV

• Surgical options:

  1. Conventional Hemorrhoidectomy (Milligan-Morgan)

  2. Laser Hemorrhoidoplasty

  3. Stapled Hemorrhoidopexy

When is Surgery Needed?

Surgery is recommended when:

• Hemorrhoids are Grade III or IV

• Recurrent bleeding despite treatment

• Severe thrombosis (clot)

• Non-surgical methods fail

Summary